Pharmacists ideally positioned to play bigger role in immunization

By Phil Emberley, Director of Professional Affairs, Canadian Pharmacists Association

April 23-30, 2016 is National Immunization Awareness Week, an occasion to remind Canadians that immunizations are safe, effective and keep communities healthy by preventing the spread of disease. We all have a role to play in the protection of our families, friends and communities by getting vaccinated.

Immunization is widely recognized as one of the world’s most successful and cost-effective health interventions, averting an estimated 2 to 3 million deaths every year according to the World Health Organization.

Despite the profound impact that vaccines have had on public health in Canada, nearly eradicating diseases that were once commonplace, instances of vaccine-preventable diseases still occur and many Canadians are still deterred from getting vaccinated due to a variety of factors like inconvenience or misinformation. Effective immunization means we need to achieve and maintain high coverage rates and ensure Canadians have easy access to immunization services and education.

Room for improvement

According to a national survey on childhood immunization coverage released by the Public Health Agency of Canada (PHAC) last year, child immunization rates in Canada are still falling short of herd immunity and Canada’s immunization coverage goals. While a large majority of Canadian children are immunized against common illness such as measles, mumps, rubella, meningitis and polio, 23 per cent of children are not receiving the full four recommended doses of the diphtheria, pertussis and tetanus vaccine by age two.

The coverage rates among adults are also a cause for concern. According to the 2014 Adult National Immunization Coverage Survey, while most individuals believed that they received all vaccines required for someone their age, less than 10 per cent were up-to-date on their adult immunizations. Clearly there is room for improvement.

Revamping our National Immunization Strategy

Although Canada has had a National Immunization Strategy in place previously, there are gaps that need to be addressed. For instance, Canada is without a national immunization registry and also lacks a harmonized routine immunization schedule. While some provincial immunization and vaccination data is available, it is not harmonized across provincial and territorial justification. In addition to improving reporting standards through a pan-Canadian approach, the coverage rates show that there is also a significant need to do more to promote and communicate the importance of immunization to public health.

Strengthening Canada’s National Immunization Strategy was a key recommendation CPhA called for during last year’s federal election campaign as well as in advance of the 2016 federal budget. We were pleased that the federal Government’s recent budget committed $25 million for PHAC to update the national immunization coverage goals and disease reduction targets, improve Canada’s ability to identify under and un-immunized Canadians, and develop a focused program to improve vaccine access and uptake.

Pharmacists’ role

Within the changing Canadian health care landscape, pharmacists are increasingly providing immunization services and evidence-based advice. According to the 2015 report Community Pharmacy: Trends and Insights, 73 per cent of pharmacies across Canada currently provide some form of immunization services, even though immunization authority for pharmacists has been in place for only a few years.

Accessibility for patients, cost savings to the health system, and reduced wait times for physicians are just a few benefits of allowing Canadians to get their vaccinations at their community pharmacy.

Take the flu shot for example, the ability of pharmacists to provide the flu shot has had a substantial impact on improving immunization rates and access across the country. In Ontario alone, more than 900,000 Canadians were vaccinated at pharmacies during the 2014-15 flu season – despite the fact the flu vaccine was only made available in Ontario pharmacies in 2012.

Pharmacists have shown the capacity and willingness to play a central role in improving immunization rates and Canadians are taking notice. According to a recent national survey, 87 per cent of Canadians trust pharmacists for advice on vaccinations. Despite this high-level of trust, pharmacists’ ability to administer vaccines for other infectious diseases isn’t consistent across Canada. Some provinces have provided pharmacists the ability to administer and even prescribe for a range of vaccines like HPV, measles, tetanus, diphtheria and whooping cough, while others have limited this ability to the flu shot.

Canadian pharmacists dispense and provide advice on 600 million prescriptions a year. Highly accessible and located in every community, pharmacists are ideally positioned to play a bigger role in administering vaccines and enhancing public awareness of immunization. When individuals are picking up prescriptions, it provides the perfect time to remind them about flu shots and other important immunizations, answer any questions they may have, and clear up any potential misinformation.

Visit immunize.ca for more information on National Immunization Awareness Week.